Howie C R, Hooper G, Hughes S P
Clin Orthop Relat Res. 1986 Aug(209):206-9.
Of 14 patients with navicular tuberosity avulsion, seven had damage to the anterior process of the calcaneum at the calcaneocuboid joint--possibly the result of an occult subluxation of the midtarsal joint. These patients were all middle-aged women who had slipped or fallen a short distance. They were unable to bear full weight because of pain on the medial and lateral aspects of the foot. The associated midtarsal injury was initially missed in five of seven patients because of failure to interpret the radiographic appearance. All seven patients had prolonged symptoms, and three had persistent but not disabling pain at least three years after injury. Degenerative arthritis had developed in the calcaneocuboid joint in four of the five patients at follow-up examinations. Patients with occult subluxation of the midtarsal joint should be managed initially by a period of non-weight-bearing followed by application of a walking cast. The need for early surgical treatment is open to question.
在14例舟骨粗隆撕脱患者中，7例在跟骰关节处出现跟骨前突损伤，这可能是中跗关节隐匿性半脱位的结果。这些患者均为中年女性，有短距离滑倒或跌倒史。由于足部内外侧疼痛，他们无法完全负重。7例患者中有5例最初因未能正确解读影像学表现而漏诊了相关的中跗关节损伤。所有7例患者症状持续时间较长，3例在受伤至少三年后仍有持续性但不致残的疼痛。随访检查发现，5例患者中有4例在跟骰关节出现了退行性关节炎。中跗关节隐匿性半脱位的患者最初应进行一段时间的不负重治疗，随后使用行走石膏。早期手术治疗的必要性尚存在疑问。
